We speak of a miscarriage if your pregnancy ends in the first 3 months. One in 4 women will experience pregnancy loss or one or more miscarriages in their lifetime. This can be a traumatic event for you and your partner.

What are the symptoms?

Usually a miscarriage starts with vaginal bleeding. That can vary from some old blood to more than a regular period. In addition, you usually also suffer from pain in your lower abdomen and decreasing pregnancy symptoms (less tense breasts, less tired and nauseous).

Sometimes it happens that you only find out during your first ultrasound that you have a miscarriage. Then we see that your baby has stopped growing, that the heart is no longer beating or we see an empty amniotic sac.

What Causes a Miscarriage?

The cause of a miscarriage is almost always a predisposition disorder. The development of the baby does not go as it should and nature finds a logical solution, as it were: it stops growing and the body rejects it.

The cause usually arises during fertilization. As a rule, these are not hereditary defects, so that there are no consequences for a subsequent pregnancy. A first miscarriage is no reason for further investigation; doctors and midwives only advise this after several miscarriages. Even then, in the vast majority of cases, it almost never provides a clear explanation for the miscarriages.

What if a miscarriage is diagnosed?

There is nothing you can do yourself to prevent the miscarriage from occurring. Therefore no treatment is possible.

In general, we see that the miscarriage continues within two weeks after the blood loss has started or after the miscarriage has been diagnosed.

Usually you will see for a few hours the blood loss and abdominal pain increase to more than a regular menstrual period. When you lose the baby or the amniotic sac, you have to imagine that you are losing clots (clotted blood). The size depends on the number of weeks of pregnancy. Such a clot can be the size of an orange and contain an amniotic sac and baby. After you have lost the amniotic sac with the baby, the blood loss decreases and the abdominal pain also decreases. The blood loss can last from a week to 10 days but should decrease every day.

There is a choice between waiting for the spontaneous course, inducing the miscarriage by means of medication or by means of a curettage (an operation under anaesthetic). Discuss with your midwife or doctor which choice is best for you.

When should you call the midwife?

It is wise to warn the midwife in the following situations:

• In case of heavy blood loss (prolonged and more than a normal menstrual period). You should call for medical help, especially if you have symptoms of seeing stars or fainting.
• If you continue to have cramping pain and/or heavy blood loss, this may indicate an incomplete miscarriage. There is still a remainder of the pregnancy in the womb. A (new) curettage may then be necessary.
• In case of fever. A temperature of 38°C or higher may indicate an inflammation in the uterus that may need to be treated with antibiotics
• In case of concern.

Physical and emotional recovery

Physical recovery after a spontaneous miscarriage or curettage is usually smooth. You may have some bleeding and brownish discharge for one to six weeks. It is wise to wait with intercourse until the blood loss is over. Getting pregnant in itself is not complicated by a miscarriage and there is no medical need to delay trying to conceive again. The next menstrual period occurs after about four to six weeks.

After a miscarriage, you can have a difficult time. Sadness, guilt, disbelief, anger and a feeling of emptiness are common emotions. It is difficult to indicate how much time is needed for this and that varies from person to person. We also know that coping with loss can be experienced or interpreted differently by women and men. Take yourself and your partner seriously in what you feel and share what you experience with each other. It is also nice to have at least 1 person, next to your partner, with whom you can also share your story.

Also see what feels good for you/you how you make this experience in memory. You can do that at any time, when it feels right. For example, a memory in a statue or jewellery, a plant or tree (you can also bury your child under it if it feels good), or a written letter to your child that was there so short. These are suggestions so see what suits you.

Another pregnancy

You can get pregnant again after a miscarriage. In most cases, a subsequent pregnancy goes well, even in women who have had more than one miscarriage. If you want to get pregnant, it is wise to live a healthy life. A miscarriage cannot be prevented, but it can provide reassurance to agree on an early (internal) ultrasound from 7 weeks of pregnancy, however, this does not guarantee the further course of the pregnancy.

Checklist : Are these complaints due to your miscarriage ? Or, for example, also after an ectopic pregnancy, molar pregnancy, the loss of a baby with twins, or an abortion.

Do you still feel all kinds of things, and do you wonder if that is normal? Or is it just part of it? Maybe you also want to know if there is anything that can be done about it? Then fill in this checklist.

What applies to you? Tick :

• I no longer have faith in my body.
• I think I cry too much about it. Or just too little.
• I still feel so often that I have failed. I feel guilty about that.
• My partner and I can't talk about it together.
• My career is on hold. I dare not take another step.
• I am much more anxious in this new pregnancy. Even extra ultrasounds don't really reassure me.
• I feel I have to do something with it, but I don't know what.
• I'm afraid I did something wrong during pregnancy.
• I find it too burdensome to tell my other child(ren).
• I have much less energy for work or friends since the miscarriage.
• I'm afraid I won't be able to handle another miscarriage.
• The sadness is much more present now that I have a living baby.
• I especially feel bad for my partner or other child(ren).
• I work on autopilot.
• I don't really feel it, is that normal?

​Did you tick one or more items? Please contact us. We can then help you to get in touch with a coach who specializes in miscarriage counseling. One meeting is enough and if necessary you can get a follow-up appointment so that you can continue with more confidence and peace of mind. Inquire about this at the practice.